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Not sure whether I've said hello before, so hello and welcome to the forums. Those are good numbers. Do you know you're CD4%? I suspect it's pretty good, as well?You have the benefit of getting labs over time and seeing what the trend is, if you are wanting to hold off on meds.

Hi there. Your numbers are very good for not being on meds. I wish my VL had been that low. I think most doctors would be OK with you holding off on meds for now.

However, you also should know that the trend is toward starting treatment ever-earlier, oftentimes regardless of absolute CD4 value. The thought is this will reduce inflammation and lessen the viral reservoir tucked away throughout the body.

You might also find yourself becoming increasingly fatigued from fighting the virus without help. I went 14 months from from catching the bug to starting meds, and felt fine the whole time. But I'm a runner, and I noticed that my mileage times were tailing off. Just getting old, I thought? But start meds, and presto, 30 seconds/mile faster on the treadmill or at the track. I don't think it was a coincidence.

Sometimes I tell people to think of HIV as any other disease. If you have diabetes or high blood pressure, you'd most likely do what you could to treat those diseases. While exercise and diet control can mitigate those particular diseases, medication is the only treatment option for HIV. So, in that context, taking medications is a the next step. (I'm not equating HIV to diabetes or high blood pressure, just using them as examples)

You have time to think about whether or not to start medications. Your CD4 count is pretty great.

Expert opinion in the US but not Europe suggests treatment at any CD4 count.

There is no uncontested, strong evidence (from randomised controlled trials or cohort studies) that treating people with CD4 counts in normal range, ie 500+, improves health, or reduces the risk of illness.

There is strong evidence that treating people with CD4 counts of under 350-500 reduces the risk of illness.

The evidence on non-treated HIV and inflammation being harmful when viral load is low (say 5000 or under) is plausible but can be read either way.

There is good reason to start treatment at any CD4 coun t to reduce the risk of transmission. This is an important benefit of treatment to think about.

To start or not to start the treatment I guess is up to the individual.I myself remember just feeling icky thinking that this virus was lurking around freely in my body.But what I would consider is, that the body really has this fantastic ability to fight back even with losing circumstances. Cancer is another good example of the body trying hard to cope.The body is in full battle mode to maintain health and fight off damage being done by the virus. While the virus is still regarded as low risk and the counts considered in the safe range, one never knows the damage being done in the background to the body.Or what the body must be going through using up resources to try and stay ahead in the battle.The body would actually use itself up trying to fight back. That is why people lose weight so badly when the body is fighting against long term disease.For me, not only was I losing weight even though still feeling healthy and still unknown to me that I was actually positive, I lost not only weight but had not noticed so much the muscle mass being lost. Especially in my typically very muscular legs. Once on meds, the virus went undetectable, immune system recovered, weight started coming back. But there are places especially in my legs where the body fighting against this virus caused muscle mass loss, that muscle mass has never quite recovered. I once again have my leg muscle back, but not at all the same consistency as before the loss.There are places where the muscle mass is now simply gone, forever.Eaten away when the body was using up resources trying to fight against this devastating disease. So I'd be extremely careful playing with the numbers and over all health while there are so many other ways this disease can tax the body long term behind the scenes.But everyone makes their own decision when to start meds.Good numbers does not necessarily mean damage is not being done behind the scene.Damage probably going unnoticed.After being diagnosed, I could not start treatment soon enough. I wanted this virus undetectable asap.(my opinion/experience for what its worth)

Those are great numbers! I was in that range for MANY years with no meds. However, that was back in the day when they didn't treat HIV until your t-cells dropped pretty low. These days most docs and research agree that treating early is best for suppression of HIV and the inflammation that is causes over time without treatment. I hope you've realized now that you can live a full and productive life with HIV and it shouldn't be an issue in fulfilling your life goals and dreams. Hope you have a Merry Christmas!